Polypharmacy, defined as taking ≥10 medications, was highly prevalent among older adults hospitalized for heart failure, occurring in 42% at admission and 55% at discharge.
Observational (n=558)
Yes
What is the prevalence and composition of polypharmacy among older adults hospitalized for heart failure?
Polypharmacy is highly prevalent and increasing among older adults hospitalized for heart failure, with the majority of the medication burden consisting of noncardiovascular drugs.
BACKGROUND: Despite potential harm that can result from polypharmacy, real-world data on polypharmacy in the setting of heart failure (HF) are limited. We sought to address this knowledge gap by studying older adults hospitalized for HF derived from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). METHODS: We examined 558 older adults aged ≥65 years with adjudicated HF hospitalizations from 380 hospitals across the United States. We collected and examined data from the REGARDS baseline assessment, medical charts from HF-adjudicated hospitalizations, the American Hospital Association annual survey database, and Medicare's Hospital Compare website. We counted the number of medications taken at hospital admission and discharge; and classified each medication as HF-related, non-HF cardiovascular-related, or noncardiovascular-related. RESULTS: The vast majority of participants (84% at admission and 95% at discharge) took ≥5 medications; and 42% at admission and 55% at discharge took ≥10 medications. The prevalence of taking ≥10 medications (polypharmacy) increased over the study period. As the number of total medications increased, the number of noncardiovascular medications increased more rapidly than the number of HF-related or non-HF cardiovascular medications. CONCLUSIONS: Defining polypharmacy as taking ≥10 medications might be more ideal in the HF population as most patients already take ≥5 medications. Polypharmacy is common both at admission and hospital discharge, and its prevalence is rising over time. The majority of medications taken by older adults with HF are noncardiovascular medications. There is a need to develop strategies that can mitigate the negative effects of polypharmacy among older adults with HF.
“Therefore, frameworks that address these challenges holistically may support goal-concordant care, earlier goals-of-care discussions, advance care planning (ACP), palliative care involvement when appropriate, and efforts to reduce caregiver burden and treatment-related adverse events.”
Ünlü et al. (Tue,) conducted a observational in Heart Failure (n=558). Polypharmacy was evaluated on Number of medications taken at hospital admission and discharge. Polypharmacy, defined as taking ≥10 medications, was highly prevalent among older adults hospitalized for heart failure, occurring in 42% at admission and 55% at discharge.